RT Journal
A1 Hoffman RM
T1 AN argument against routine prostate cancer screening
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2003
FD March 24
VO 163
IS 6
SP 663
OP 665
DO 10.1001/archinte.163.6.663
UL http://dx.doi.org/10.1001/archinte.163.6.663
AB
Prostate cancer is an important public health problem—a devastating disease that was expected to have killed more than 30 000 American men in 2002.1 Unfortunately, our current prevention and treatment strategies are limited in their ability to reduce the burden of suffering from prostate cancer. The strongest risk factors are age, race, and family history, none of which can be modified. Although dietary micronutrients, antioxidant vitamins, and finasteride are being studied for the primary prevention of prostate cancer, we currently have no proven prevention strategy. Men with advanced cancers can be treated only with palliative therapy. Consequently, there has been great interest in detecting prostate cancers at an early, asymptomatic stage, especially since the discovery of PSA. The hope is that detecting early stage cancers and treating them aggressively with surgery or radiation will reduce morbidity and mortality from prostate cancer. The American Urologic Association2 and the American Cancer Society3 support routine screening for prostate cancer using PSA and DRE. However, other professional organizations, such as the American College of Physicians–American Society of Internal Medicine4 and the US Preventive Services Task Force5 recommend against routine screening.